In elderly women, the bladder and proximal urethra tend to descend from their normal anatomic positions such that the bladder neck and proximal urethra move away from the posterior wall of the pubic bone, producing a condition known as stress urinary incontinence (SUI). This condition may be treated surgically, using sutures to fasten periurethral tissue to the pubic bone as a means of repositioning and resuspending the bladder and proximal urethra. The sutures are anchored to the pubic bone using bone anchor screws.
Bone anchor placement devices, such as bone anchor drivers, may be used to place a bone anchor screw at a selected insertion site in the bone. Either percutaneous or transvaginal surgical procedures may be performed using such devices. Percutaneous procedures require an incision in the abdominal wall and/or anterior vaginal wall in order to introduce the bone anchor placement device and are necessarily invasive and traumatic to the patient. Transvaginal such procedures are cost-limiting and may not be readily available when required to perform surgery. Typical bone anchor placement devices used in transvaginal procedures are configured like power drills and are cannulated.
A suture may be threaded into a bone anchor screw prior to, or after, its insertion into the pubic bone. Load on a suture at the point of attachment of the suture to the bone anchor screw can cause breakage of the suture requiring additional, undesired surgery.